Subretinal Drug Delivery in Wet Age Related Macular Degeneration with Sub-macular Hemorrhage
Introduction: To evaluate the surgical outcomes of a modified approach in the management of thick submacular haemorrhage in patients with wet age related macular degeneration (amd). Design: Retrospective study. Participants: 10 eyes of 10 patients with dense submacular haemorrhage. Methods: A retros...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2014-10-01
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| Series: | Delhi Journal of Ophthalmology |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.7869/djo.87 |
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| Summary: | Introduction:
To evaluate the surgical outcomes of a modified approach in the management of thick submacular haemorrhage in patients with wet age related macular degeneration (amd).
Design:
Retrospective study.
Participants:
10 eyes of 10 patients with dense submacular haemorrhage.
Methods:
A retrospective chart review of 10 eyes of 10 patients with submacular haemorrhage secondary to wet amd treated with 23g pars plana vitrectomy (ppv),followed by submacular injection of recombinant tissue plasminogen activator (r-tPA) (12.5µg/0.1ml), bevacizumab (2.5mg/0.1ml) and air (0.3ml). Gas tamponade was given with 20% sf6 and postoperative propped up positioning. Patients were evaluated for displacement of haemorrhage, pre and post-operative best corrected visual acuity (bcva), occurrence of intraoperative and postoperative complications and recurrence of hemorrhage. All patients were followed up for 6 months.
Results:
complete pneumatic displacement of the subretinal bleed from the macula was seen in all the patients on the first postoperative day. Improvement of bcva was seen in 8 out of 10 patients. Rebleed was seen in 2 eyes which were retreated with intravitreal injection of r-tpa, bevacizumab and 20% sf6 gas injection.
Conclusion:
This modified technique aids in effective displacement of thick submacular hemorrhage with simultaneous treatment of the underlying choroidal neovascular membrane, which halts the disease progression resulting in desired anatomical and functional outcomes. |
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| ISSN: | 0972-0200 2454-2784 |